Individualistic approach to the management of complete hydatidiform mole with coexisting live fetus

Abstract

Complete hydatidiform mole with a coexisting live fetus (CHMCF) is a rare obstetric occurrence. So far, approximately 177 cases have been documented in the literature with consequent 66 live births. We report a review article along with two cases of CHMCF, one presenting as incomplete abortion and other continued as CHMCF but terminated because of antepartum hemorrhage. Both had histopathologically proven one normal and other complete molar placenta with coexisting normal fetus. No evidence of persistent trophoblastic disease was observed. The dilemma of continuation versus termination of pregnancy is being emphasized in the review of literature. Pregnancy complicated by CHMCF may result in a viable live born infant in approximately one third of the cases. A potentially viable fetus with CHMCF may result in normal live birth with antecedent high risk maternal complications. A decision of termination of pregnancy in all CHMCF will however nullify all the chances of a live birth. An individualistic approach and an informed doctor patient consensus may improve the likely outcome. Appropriate counseling of the mother regarding high incidence of antenatal complications plays an integral part of decision of continuation of such pregnancies.

Keywords: Co-existent live fetus; Complete mole; Twin pregnancy.